I started vemlidy March 29, 2022 ; HBV DNA undectable after 3 months of Vemlidy. (HBV DNA was around 2,000 to 3,500 iu/ml, AST/ALT normal before treatment)
I switched to entecavir 0.5mg in November, 2022 due to high price of Vemlidy. My HBV DNA is still undectable as of today.
I just stopped Vemlidy for 1 day before switching to Entecavir. You should consult your doctor on how to switch to entecavir.
I think entecavir has less side effects than TDF, TAF.
You may find this article interesting:
Risk of dyslipidemia in chronic hepatitis B patients taking tenofovir alafenamide: a systematic review and meta-analysis
Eui Gwon Hwang, Eun-Ae Jung, Jeong-Ju Yoo, Sang Gyune Kim & Young Seok Kim
Hepatology International volume 17, pages 860–869 (2023)
Conclusions
TAF continues to worsen lipid profiles including LDL-c, TC(Total Cholesterol), and TG(Total triglyceride) after 6 months of use compared to the other NAs.
i would switch to etv 1mg and retest after 6months, i personally stopped tdf for severe side effects on kidneys, osteopenia and humeral head osteonecrosis.of course this is after many years of use like you
for example also my mother cant tollerate TAF and switched back to etv
etv is less potent on hbsag but if there is no continuous decline it is more important to use the safest nuc
Switching to entecavir will not help much, however personally I find only one advantage that entecavir causes a higher cure rate than tenofovir. But that is very meagre.
Rising cholesterol in thin person is not an uncommon phenomenon. There are various familial and genetic predisposition to dyslipidemia. So simple answer is u should change your diet(low oily and spicy, add daily fresh fruits), keep an active life style with walking and exercise, medications are tab Atorvastatin daily once and nicotinamide (vit b complex) daily. This will help
I think your doctor is wrong on this.
Tenofovir alafenamide (TAF), has been linked with slight increases in LDL cholesterol. However, research suggests the risk may be modest. Tenofovir disoproxil fumarate (TDF) has been linked with a lowering of lipids, but the clinical significance of this finding is not known